With his recent [September 18] New York Times‘s Opinionator piece, “Medicine’s Search for Meaning,” David Bornstein stumbled upon a phenomenon—a cache of disaffected, frustrated, angry doctors, the same cache I’ve stumbled on with GOD’S HOTEL, and its message that the best medicine is often Slow Medicine. So many doctors wrote in response that Bornstein wrote a follow-up essay on October 2, “Who Will Heal the Doctors?” and hundreds more doctors have responded to that.
Imagine how many doctors those hundreds represent!. . . And you don’t have to imagine, I can tell you—they represent thousands. The thousands of doctors who are retiring early because they can’t stand not being able to practice real medicine. The thousands of doctors who are dropping out to set up concierge or boutique or direct patient practices—so they have enough time to do a good job. The thousands more with medical school loans and years to go who are seething; their anger soon to boil and then reduce into a mixture of depression and withdrawal.
What do all these doctors want? More money?
Not exactly. More money, sure why not, but more important, they want their profession, their calling, back, with its values of service and respect. They want not to be healthcare providers, or worse, healthcare data providers. Above all, they want—we want—our time back with our patients.
That’s the real bottom line. Nothing—no healthcare efficiencies, no computer algorithms—can shorten the time it takes for a doctor to do a good job—which means listening to the patient, doing a thorough exam, going over labs, formulating the diagnosis and coming up with the plan.
After seeing the effect of his piece, Bornstein had the thought that what doctors need is a movement, a kind of “Occupy Medicine.”
But don’t doctors already Occupy Medicine?
Alas, they don’t, having been pushed out of that property by healthcare economists, bureaucrats, administrators and all their consequent rules, regulations, and forms, which now take up seventy percent of our time, as recent studies have shown.
Well then, why not re-occupy Medicine, for one day at least? A Slow Medicine Day, perhaps? A day where doctors choose not to fill out forms but instead spend our time with our patients. What would happen? If doctors took all the time they needed on one particular day? Would it take us until midnight to see our patients? Or with all the extra time we’d have from not filling out forms, would we end up seeing our patients in the same amount of time or even less?
Certainly we would see them better and therefore more efficiently, since with all the time we needed to listen, examine, and think we would get closer to their real diagnoses and their correct treatments. And nothing is more cost-effective than that.